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Biomedical subjects

D S Cook

Publications and source records attributed to D S Cook.

8 recordsLinked to original sources
PubMed2000

'Mucin-positive' epithelial mesothelioma of the peritoneum: an unusual diagnostic pitfall.

AIMS: The histopathological, immunohistochemical and ultrastructural features of a primary 'mucin-positive' epithelial mesothelioma of the peritoneum are reported to draw attention to a potential cause of diagnostic error. METHODS AND RESULTS: Light microscopy showed an infiltrative neoplasm within the gastric wall and omentum which was composed of sheets of 'signet- ring' tumour cells and contained abundant diastase-resistant periodic acid-Schiff-positive material. Immunohistochemistry supported a mesothelial phenotype (cytokeratin AE1/3, thick membranous HBME-1, focal thrombomodulin and calretinin expression and no reactivity for carcinoembryonic antigen, Leu-M1 and Ber-EP4). Ultrastructural features showed large cells with prominent intercellular desmosomes and numerous delicate, elongated microvilli. Within intracytoplasmic neolumina, crystalloidal 'fern-like' bodies were identified with features similar to the ultrastructural appearances of hyaluronic acid crystals. Repeat histochemical analysis following hyaluronidase pretreatment revealed a significantly diminished diastase-resistant periodic acid-Schiff reaction. CONCLUSIONS: This case of primary peritoneal 'mucin-positive' epithelial mesothelioma demonstrates morphological and histochemical mimicry with diffuse gastric adenocarcinoma. A similar case has not been previously reported in the peritoneum and an awareness of the tumour (with application of suitable ancillary studies) prevents misdiagnosis and assists in potentially difficult medicolegal cases.

Adenocarcinoma↗
PubMed2000

Estimating antemortem drug concentrations from postmortem blood samples: the influence of postmortem redistribution.

AIMS: To compare blood drug concentrations during life with postmortem drug concentrations measured from a peripheral site and a central site. METHODS: Coroner's cases from October 1990 to July 1997 were reviewed. Six cases had data on both antemortem and postmortem blood drug concentrations. The postmortem to antemortem ratio was compared with the postmortem central to peripheral ratio, using cardiac blood as a central site and femoral blood as a peripheral site. RESULTS: Drugs that have a high postmortem central to peripheral ratio; that is, drugs that exhibit considerable postmortem redistribution, also have high postmortem to antemortem ratios. CONCLUSIONS: A large degree of error can arise from attempting to estimate antemortem drug concentrations and the ingested dose from postmortem measurements. The chosen site and technique for postmortem blood sampling can greatly influence the concentration of drug measured.

Adolescent↗
PubMed1988

Evidence for insulinotropic effect from rat parotid glands.

Previous observations have suggested that the salivary glands exercise a regulatory role on insulin secretion and/or glucose metabolism. We have challenged the issue by studying in unanesthetized, unrestrained rats the short- and long-term effect of selective sialoadenectomy on the animals' ability to meet an intra-arterial glucose challenge. Ten-minute intra-arterial glucose tolerance tests were carried out in chronically catheterized adult rats before and after sialoadenectomy. Eighty-five to 100 days postsurgery, the parotidectomized rats experienced a 45% reduction in plasma immunoreactive insulin output (P less than .001) compared with the sham-operated animals; the plasma glucose levels of the test subjects remained 19% higher (P less than .001) than those of the control group. In younger rats, similar observations were made; however, the difference in insulin and glucose responses between treatments was less than in the adult rats. Our findings suggest that the insulinotropic effect resides primarily with the parotids, and the role of the submandibular glands seems to be permissive at best. We hypothesize that parotidectomy deprives the beta-cells of a humoral principle that appears to be essential for optimizing the immediate insulin response to a glucose challenge. These results suggest that the insulinotropic effect of the parotids is of particular importance when aging changes insulin secretion and action.

Animals↗